基于临床及超声特征的列线图模型预测甲状腺结节良恶性的临床价值

打开文本图片集

Prediction of benignand malignant thyroid nodules based on a nomogram model of clinical and ultrasound featuresJin E* ，LiJuan， QiDong，DongNan.*DepartmentofUltrasound，theFirst People'sHospitalofBengbu，Anhui 233000， China

【Abstract】ObjectiveTo investigate the clinical value of a nomogram model based on clinical and ultrasound features to predictthe benign and malignant natureof thyroid nodules.MethodsClinicaland ultrasounddata of 100 patients with thyroid nodules confirmed byultrasound-guided fine-needleaspiration biopsy （FNT）from January 2021 to June 2O24atour hospital were retrospectivelyanalyzedand divided intoatrainingset （n=7O）andavalidation set 0 n =30）according toa7：3ratio.Clinicaldataandultrasound imaging characteristicsof the training set were analyzed byunivariateand multivariate analysis，and clinical and ultrasound models wereconstructed，respectively，and，finally， acolumn-line diagram model was constructed bycombining clinical-ultrasound independent risk factors.The predictive efficacy of each model was evaluated by applying receiver operator characteristic curve （ROC），calibration curves， and clinical decisioncurves （DCA），and Delong's test was used to evaluate the diffrences in the area under the curve （AUC）of eachmodel.ResultsMultifactorialLogisticregresionanalysisultimatelyscreenedfor2clinicalindependentrisk factors （thyroglobulin，thyroid-stimulating hormone）and4ultrasound independentrisk factors （aspectratio， margins，microcalcifications，and blood flow）.The ROC curve analysis showed that the AUC values （ 95% CI）of the training setand validation setof thecolumn line graph model were 0.921（0.892，0.931）and 0.919（0.871，0.947），respectively.The Delong test showed that the AUC values of the column line graph model were higher than that of the clinical model and ultrasound model （both P<0.05 ）.The calibration curve analysis showed that the predicted probabilitycurveof thecolumn-line diagram model was the closesttothe idealcurve.The DCA analysis showed thatthe area underthe curveof thecolumn-line diagram model was the largest，and ithada higher clinical netyield.Conclusion Clinical and ultrasound-based nomogram models can effectively predict benign and malignant thyroid tumors and provide a reference basis for standardized clinical treatment.

【Key words】 Thyroid nodule; Ultrasonography;Clinical features;Nomogram mode

甲状腺结节是指甲状腺内出现的单个或多个局限性肿块，是临床常见的疾病之一，大多结节为良性，其中 7%～15% 存在恶性可能[1]，其良恶性的诊断对于患者的治疗方案和预后具有重要影响。（剩余10158字）